Group Lead, Operations Account Management

The Group Lead, Operations Account Management is responsible for overseeing operational performance and execution across a portfolio of assigned clients, serving as the senior operational liaison between client facilities and internal delivery teams. This role provides leadership over tactical revenue cycle execution, ensuring accurate reporting, effective communication, and consistent, high‑quality performance across billing, follow‑up, collections, denials, and claim resolution workflows.

This position holds expanded accountability for operational monitoring, client relationship management, and issue resolution across multiple accounts or teams. The Group Lead translates client needs into prioritized operational strategies, monitors key performance indicators, identifies systemic risks and trends, and drives timely resolution to protect cash, A/R performance, and client satisfaction.

The role also provides leadership and mentorship to operational leads and staff, reinforcing execution standards, supporting training and performance improvement efforts, and removing barriers to delivery. Success is measured by client retention, escalation reduction, cash performance, A/R outcomes, and overall service stability.

These goals and objectives are not to be construed as a complete statement of all duties performed; employees will be required to perform other job-related duties as required.  Goals and objectives are subject to change.

All activities must be in compliance with Equal Employment Opportunity laws, HIPAA, ERISA and other regulations, as appropriate. 

Essential Functions:

In addition to meeting performance expectations, this role includes the following specific responsibilities:

Discrete Responsibilities (Primary Accountability)

• Operational Performance Oversight: Oversee daily operational performance, battle cards, action plans, and key KPIs across assigned clients, including A/R days, cash performance, denial trends, and accuracy measures.
• Senior Operations Liaison: Serve as the primary senior operational point of contact for clients, ensuring proactive, accurate, and consistent communication between client stakeholders and internal delivery teams.
• Operational Prioritization & Direction: Translate client needs, issues, and requests into prioritized operational actions and execution plans across teams.
  Risk & Trend Leadership: Identify emerging operational risks and performance trends; guide corrective actions to prevent revenue leakage and service disruption.
• Executive‑Ready Reporting & Communication: Ensure accurate reporting, consolidated performance insights, and clear status updates for internal leadership and client stakeholders.
  Client Scope: Lead operational work for domestic clients, with responsibility for coordination and consistency across assigned accounts.

Reporting, Trend Monitoring & Continuous Improvement

• Trend Analysis & Corrective Action Leadership: Review dashboards and performance data to identify trends, risks, and deficiencies; lead the development and execution of corrective action plans to improve outcomes.
• Operational Optimization: Drive operational efficiency and reimbursement optimization through standardization, workflow alignment, issue triage, and cross‑functional collaboration.
• Scalability & Consistency: Ensure consistent execution standards and operational approaches across teams and client portfolios.

Client & Stakeholder Relationship Management (Tactical–Strategic Bridge)

• Client Engagement & Communication: Maintain strong, trusted relationships with client operational stakeholders, ensuring timely issue resolution and transparent communication.
• Escalation Ownership: Proactively manage and escalate significant operational risks (e.g., unbilled, denials, cash variance, system issues) with clear timelines and mitigation plans.
• Cross‑Functional Leadership: Partner with operations, finance, payer relations, technology, and strategic client management counterparts to drive resolution and protect the client experience.
• Contract Awareness & Compliance: Ensure operational execution aligns with contractual requirements, billing standards, and service‑level commitments.

Compliance & Professional Standards

• Regulatory & Industry Knowledge: Maintain current knowledge of hospital billing systems, government payer programs, third‑party reimbursement policies, and applicable federal and state regulations.
  Confidentiality: Maintain strict confidentiality of patient and client information without exception.
• Continuous Learning: Attend required meetings and remain current on industry trends, regulatory changes, and operational best practices.
• Customer Invoicing & Accuracy: Oversee accuracy of customer invoicing and support monthly invoicing processes as required; validate supporting documentation and address discrepancies.
• Management Expectations / Additional Duties: Perform all functions in alignment with management expectations and complete additional duties as assigned.

Key Measures of Success

• Client Retention and Stability
• Reduction in Client Escalations
• Cash Performance vs. Goal
• A/R Days and Denial Trends
• Consistency of Operational Execution Across Accounts

Staff Management

Responsible for ensuring area of responsibility has the talent and resources to meet short- and long-term organizational goals as well as ensuring maximum productivity and performance.  Responsibilities include, but are not limited to:

• Proactively recruit, screen, and select candidates for current and future resource requirements.
• Effectively orient new hires to ensure a positive and productive employee engagement experience.
• Ensure structure and hiring plans (within budget) are appropriate for performance and productivity levels required.
• Utilize the company’s performance management program as designed to align individual performance to overall performance objectives.  Meet all completion requirements at a high quality level.  Provide ongoing performance feedback.  Identify and take appropriate action for non-performance.
• Ensure each employee has a yearly performance review that is reviewed with employee and the review to be sent to Human Resources each year.
• Ensure each employee has a clear and thorough understanding of their role and responsibilities.  Keep job descriptions current for each position.
• Actively support and participate in organizational development and training programs.  Meet all completion requirements at a high quality level.
• Mentor, guide, and coach direct reports in order to expand their capabilities and performance.
• Communicate all corporate matters in a positive and timely manner as directed by Corporate Communications or senior managements. 
• Administer all internal policies and procedures in accordance with corporate, human resources, budgetary, and finance guidelines.  Ensure accuracy of staff data records.
• Comply with all employment laws and regulations including, but not limited to, equal employment opportunities for all.

Minimum Requirements:

Education/Experience/Certification Requirements

• Bachelor’s degree or equivalent combination of education and relevant experience.
• 7+ years of progressive experience in hospital revenue cycle operations, with demonstrated leadership responsibility across billing and collections functions.
• 5+ years of manager experience
• Advanced working knowledge of insurance regulations, reimbursement practices, coding interfaces, and automated billing workflows.
• Demonstrated ability to lead complex issue resolution, systemic root-cause analysis, and multi-team corrective actions.
• Strong executive-level communication skills with the ability to present operational insights, risks, and recovery plans clearly and effectively.
• Excellent analytical, organizational, and prioritization skills with a proven ability to manage competing demands.
• Advanced proficiency in Microsoft Office tools (Excel, Outlook, Word) and comfort interpreting multi-source reporting.

Preferred Qualifications:

• Bachelor’s or Master’s degree in Healthcare Administration, Business, Finance, or related field.
• 5+ years Medicare hospital billing experience and demonstrated expertise with government payers.
• Experience supporting multiple hospital billing platforms and/or EHR/RCM systems (e.g., Thrive, Epic, Cerner).
• Advanced revenue cycle analytics experience, including KPI governance, trend analysis, and executive reporting.
• Prior experience in senior operational leadership, client escalations, service recovery, and cross-functional governance.
• Experience overseeing invoicing processes, contract compliance validation, and operational performance frameworks.

Working Environment/Physical Demands

Working Environment:

• General office environment: Works generally at a desk in a well-lighted, air-conditioned cubicle/office, with moderate noise levels. 
• Periods of stress may occur.

Physical Demands:

• Activities require a significant amount of sitting at office and work desks and in front of a computer monitor.
• Some walking and standing relative to interaction with other personnel. 

Travel Requirements:

    None          Occasional           Moderate           Frequent           Very Frequent

                        (25% or Less)      (25% - 40%)           (40% - 80%)                      (80% or more)

Other possible Unofficial Titles:

Unofficial titles may be given by the manager and used for calling cards and email signatures.

Manager